Trauma & Orthoapedics, Walsall Manor Hospital, United Kingdom.
Visiting Felow, Walsall Manor Hospital, United Kingdom.
J Pak Med Assoc. 2021 Aug;71(Suppl 5)(8):S41-S44.
To establish a relationship between sub acromial bursa and shoulder impingement by determining its presence or absence in sub acromial space. To determine the novel prospects and favourable outcome after surgery in shoulder impingement syndrome.
Over 1000 patients with the diagnosis of shoulder impingement were studied from 2003 to 2020 at Manor Teaching Hospital, Walsall, UK. During Arthroscopy, the findings were noted and documented. The sub acromial bursa and its presence or absence was noted along with kissing lesion of supraspinatus confirmed at Arthroscopy. Functional outcome in all patients was assessed with q-Dash score and pain relief was documented with VAS (Visual Analogue Scale).
Sub acromial decompression did not completely resolve symptoms in 649(64.9%) patients having adequate bursa and no kissing lesion. Therefore, a cause other than acromion impingement was considered. However, in 351(35.1%) patients without any bursal tissue, sub acromial decompression alone had better results. Mean post-operative q-DASH score in group A (Bursa present) was 49.21±41 and in group B (Empty Bursa) it was 35.73±23. Mean post-operative VAS (Visual Analogue Scale) score in group A was 6.5±2.3 and in group B, it was 4.1±2.1.
We report that the presence of kissing lesion and an empty Bursal space under the acromion is a high predictor of successful outcome after arthroscopic decompression.
通过确定肩峰下囊在肩峰下间隙中的存在或缺失，来确定肩峰下囊炎与肩峰撞击之间的关系。探讨肩峰撞击综合征患者手术后新的前景和良好的结果。
2003 年至 2020 年，在英国沃索尔庄园教学医院对 1000 多名诊断为肩峰撞击症的患者进行了研究。在关节镜检查过程中，记录并记录了检查结果。注意并记录肩峰下囊及其存在或缺失情况，以及关节镜下确认的冈上肌“亲吻”病变。使用 q-Dash 评分评估所有患者的功能结果，使用 VAS（视觉模拟量表）记录疼痛缓解情况。
649 例（64.9%）有足够肩峰下囊且无“亲吻”病变的患者行肩峰下减压术，症状并未完全缓解，因此考虑除肩峰撞击以外的其他原因。然而，在 351 例（35.1%）无任何肩峰下囊组织的患者中，单纯行肩峰下减压术效果更好。A 组（有囊存在）术后 q-DASH 平均评分为 49.21±41，B 组（无囊）为 35.73±23。A 组术后 VAS（视觉模拟量表）平均评分为 6.5±2.3，B 组为 4.1±2.1。
我们报告称，冈上肌“亲吻”病变和肩峰下囊下的空囊是关节镜下减压术成功的重要预测因素。
